TY - JOUR
T1 - Indoor and outdoor artificial light-at-night (ALAN) and cancer risk
T2 - A systematic review and meta-analysis of multiple cancer sites and with a critical appraisal of exposure assessment
AU - Palomar-Cros, Anna
AU - Deprato, Andy
AU - Papantoniou, Kyriaki
AU - Straif, Kurt
AU - Lacy, Paige
AU - Maidstone, Robert
AU - Adan, Ana
AU - Haldar, Prasun
AU - Moitra, Saibal
AU - Navarro, José Francisco
AU - Durrington, Hannah
AU - Moitra, Subhabrata
AU - Kogevinas, Manolis
AU - Harding, Barbara N.
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/12/10
Y1 - 2024/12/10
N2 - Exposure to artificial light-at-night (ALAN) has been linked to cancer risk. Few meta-analyses on this topic have reviewed only breast cancer. This study aimed to systematically review and meta-analyze existing studies on ALAN exposure and cancer incidence, thoroughly evaluating exposure assessment quality. We considered observational studies (cohort, case-control, cross-sectional) on ALAN exposure (indoor and outdoor) and cancer incidence, measured by relative risk, hazard ratio, and odds ratio. We searched six databases, two registries, and Google Scholar from inception until April 17, 2024. Quality of studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Random-effects meta-analysis was used to estimate relative risks (RR) and 95 % confidence intervals (CI) for ALAN exposures. We identified 9835 studies and included 28 for qualitative synthesis with 2,508,807 individuals (15 cohort, 13 case-control). Out of the included studies, 20 studies on breast cancer (731,493 individuals) and 2 studies on prostate cancer (53,254 individuals) were used for quantitative synthesis. Higher levels of outdoor ALAN were associated with breast cancer risk (meta-estimate = 1.12, 95 % CI 1.03–1.23 (I2 = 69 %)). We observed a non-significant positive association between indoor ALAN levels and breast cancer risk (meta-estimate = 1.07, 0.95–1.21, I2 = 60 %), and no differences by menopausal status. The meta-analysis for prostate cancer suggested a non-statistically significant increased risk for higher levels of outdoor ALAN (meta-estimate = 1.43, 0.75–2.72, I2 = 90 %). In the qualitative synthesis, we observed positive associations with non-Hodgkin lymphoma and colorectal, pancreatic and thyroid cancer. We found an association between outdoor ALAN and breast cancer risk. However, most studies relied on satellite-images with a very low resolution (1 to 5 km, from the Defense Meteorological Program [DMSP]) and without information on color of light. Future studies with better exposure assessment should focus on investigating other cancer sites.
AB - Exposure to artificial light-at-night (ALAN) has been linked to cancer risk. Few meta-analyses on this topic have reviewed only breast cancer. This study aimed to systematically review and meta-analyze existing studies on ALAN exposure and cancer incidence, thoroughly evaluating exposure assessment quality. We considered observational studies (cohort, case-control, cross-sectional) on ALAN exposure (indoor and outdoor) and cancer incidence, measured by relative risk, hazard ratio, and odds ratio. We searched six databases, two registries, and Google Scholar from inception until April 17, 2024. Quality of studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Random-effects meta-analysis was used to estimate relative risks (RR) and 95 % confidence intervals (CI) for ALAN exposures. We identified 9835 studies and included 28 for qualitative synthesis with 2,508,807 individuals (15 cohort, 13 case-control). Out of the included studies, 20 studies on breast cancer (731,493 individuals) and 2 studies on prostate cancer (53,254 individuals) were used for quantitative synthesis. Higher levels of outdoor ALAN were associated with breast cancer risk (meta-estimate = 1.12, 95 % CI 1.03–1.23 (I2 = 69 %)). We observed a non-significant positive association between indoor ALAN levels and breast cancer risk (meta-estimate = 1.07, 0.95–1.21, I2 = 60 %), and no differences by menopausal status. The meta-analysis for prostate cancer suggested a non-statistically significant increased risk for higher levels of outdoor ALAN (meta-estimate = 1.43, 0.75–2.72, I2 = 90 %). In the qualitative synthesis, we observed positive associations with non-Hodgkin lymphoma and colorectal, pancreatic and thyroid cancer. We found an association between outdoor ALAN and breast cancer risk. However, most studies relied on satellite-images with a very low resolution (1 to 5 km, from the Defense Meteorological Program [DMSP]) and without information on color of light. Future studies with better exposure assessment should focus on investigating other cancer sites.
KW - Artificial light-at-night
KW - Cancer
KW - Circadian disruption
KW - Meta-analysis
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85207292225&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2024.177059
DO - 10.1016/j.scitotenv.2024.177059
M3 - Review article
C2 - 39437923
AN - SCOPUS:85207292225
SN - 0048-9697
VL - 955
JO - Science of the Total Environment
JF - Science of the Total Environment
M1 - 177059
ER -